About a month ago, my wife tripped while hiking and hit her head. We went to our Emergency Department and they did a CT scan, which was “clean.” Other than an occasional headache, my wife feels fine. Is there a time when we can stop worrying?
The CT scan that was done in the Emergency Department is helpful because it showed there was no bleed in your wife’s head (hemorrhage) that would require surgery. That being said, most of the time after a concussion — or mild brain injury — a CT scan does not show any evidence of injury and yet some people may continue to have symptoms related to the concussion. The injury to the brain in a concussion is generally to the neurons and axons that are microscopic and therefore not seen on CT scan. Symptoms can be broken down into four categories:
- Cognitive issues, including memory and concentration
- Sleep issues, including too much or too little sleep, drowsiness, and difficulty falling asleep
- Physical issues, including headaches, decreased balance, dizziness, impaired vision, fatigue, nausea/vomiting, and sensitivity to light and noise
- Emotional issues, including irritability, sadness, and nervousness
Many symptoms from mild traumatic brain injuries resolve themselves with some time and rest and it seems this is the case with your wife. However, if her headaches do not continue to improve, if they are limiting your her function, or if they worsen, it would be appropriate to take her for a re-evaluation by your physician.
Dr. Brian Greenwald is medical director of Center for Head Injuries and the associate medical director of JFK Johnson Rehabilitation Institute. He is a clinical associate professor in the Department of Physical Medicine and Rehabilitation at UMDNJ-Robert Wood Johnson Medical School.